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Providing straightforward information pertaining to drugs, drug use & drug policy. The Grey Pages promotes drug-related literacy and advocates a system of viable and tolerant drug policies. This is my personal collection of commentaries, essays, tid-bits, and other such writings on everything ranging from drug use, drug policy and drug-myths, to drug-science, addiction, human behavior, and the workings of the human brain. I started this blog with a particular focus on opioids, and over the past year have found my interest gravitate toward the intriguing, ever-changing world of designer intoxicants (i.e. "research chemicals" or "designer drugs").

Thursday, April 19, 2012

A Self Contradiction in the Brain Disease Model

I discovered an interesting piece at thecleanslate.org. This site is similar to my own only in that it takes a strong position against the disease model of addiction and the "treatment" industry that it's subsequently spawned. Now, I'll briefly summarize what this piece has already explained so well...The particular section in this piece I'm referring to is "The Stolen Concept of Neuroplasticity in the Brain Disease Model of Addiction" (5 sections down).

The author explains how the brain disease model of addiction rests on the concept of neuroplastic changes in brain function, while simultaneously denying this very biological concept.

In summary, proponents of the disease of addiction and its treatment by medical means have relied heavily on one piece of evidence in particular, in supporting their conclusion that addiction is in fact a disease state - this being the well established adaptive process of long term plasticity underlying long term reinforcement and learning in response to chronic-heavy drug use.

On the surface, this makes sense. However, to exploit this principle for their own gain and establish a market of chronic, even lifelong, medical clientele, disease proponents have had to pull somewhat of a bait & switch. According to the chronic brain disease model, the crucial aforementioned process of neuroplasticity in response to drug use only goes in one direction. Once the brain has undergone the process of becoming chemically dependent, the biological process of neuroplasticity upon which proponents have so heavily relied, becomes obsolete. So according to disease proponents, once the brain has learned to prioritize drug use, the basic rules of neurochemistry no longer apply. The brain somehow remains in a frozen, perpetually drug dependent state (the catch being that only a regimen of life long "medical treatment" and "recovery" will remedy this chronic condition).

This phenomenon of "one way plasticity" is never expressly mentioned by anyone in the treatment field. And doing so would immediately point out the major flaw in this theory. Fortunately for the purveyors of this brain disease model, their theory can be represented to the layperson in a relatively straightforward manner; also, the inner workings of the brain being as intricate as they are, few in the general public would ever ponder the nature of neuroplasticity, much less know what it is.

When you start speaking about neuroscience to the average person, they shut down a bit and accept whatever conclusions you reach. The reason why is that we’re laymen, we hear the scientific jargon, assume the speaker is an expert and knows what they’re talking about, and we suspend judgment. Steven Slate (thecleanslate.org)

This unspoken underlying assertion is of course, not true. Just as the limbic brain can develop a chemical dependence through neuroplastic adaptation (the synaptic potentiation of drug associated pathways), the limbic brain can and will un-develop a chemical dependence through the very same mechanism (the eventual reduction in function of the aforementioned drug associated pathways), with extended periods of abstinence. This basic biological principle occurs constantly throughout our lives; falling in love and then out of love, developing a positive taste for particular food and eventually losing your taste for that food, learning to play the piano and eventually forgetting how to play the piano, making and breaking your daily habits. The process of drug dependence is no exception - the associated instinct & behavior is learned and can be un-learned.

5 comments:

It's clear that the person writing these essays has never experienced addiction. As someone who is an addict in Recovery, I find the ideas posted here dangerously misinformed. One of the most baffling things about this disease (and yes, I believe that addiction/alcoholism are diseases), is my complete inability to control or change my substance using behavior despite a strong desire to do so. I would go to bed nightly with the same heartfelt vow - that I would NOT get up the next day and continue the same behavior. The result? Before I was out of bed the next day I was repeating the same behavior - I couldn't change that pattern despite wanting to and I couldn't understand why I was unable to change. Then, in Recovery, with a strong support system and desire to remain in Recovery, I continued to experience the same out of control obsession/craving and use when given opiates for post-operative pain management. I compare it to the Flintstone cartoon with the angel on one shoulder & devil on the other. My brain can almost have a conversation with the two halves - the healthy, non-substance abusing part with the addict, for whom more is ALWAYS better & there is never enough. I believe the ideas posted on this site are irresponsible and dangerous. They may have some applicability to those who are truly social users......but for those of us who are truly addicts/alcoholics and not just abusers, experimenting with the ideas proposed here can be a deadly proposition.

Why is it that people in "recovery", almost always defined by adherence to 12-step AA/NA programs, are so hostile to alternative views of the addictive experience. You say you cannot change your substance using behavior, but getting high requires several conscious steps. You have to get money, go to a drug supplier and then ingest the substance. These all require conscious choices, it's not like trying to control your heartbeat. And you somehow managed to find the will to enter recovery, how is this possible if your brain was diseased and you couldn't stop getting high? Divine Intervention?The author obviously has experience with addiction. That his views are so different from the mainstream NIDA paradigm I for one find refreshing. Because he does not endorse your definition of "recovery" is no reason for ad hominem attacks.

although I do somewhat agree with the above comment, I think DM the dude who posts these essays is trying to say that anyone can get clean and sober, if they want it bad enough, and if access to treatment, and 12 step fellowships is not available or not wanted, that there is hope, one can abstain from chronic drug addiction. I am a drug addict, and im about to under go the whole treatment industry thing, but im not sure ive ever bought fully into the disease concept. I do however acknowledge totally how one can want to stop using with EVERY fibre of their being, and yet STILL CONTINUE, and this is where it becomes hard to make sense of, in that neither theory gives a satisfactory explanation. I havnt studied chemi, but i am degree educated and as I read, a little of the psych/bio i studied is coming back....but not much lol.